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General NPI Number Information
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NPI Number | 1902595671
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Entity Type | Organization
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Legal Business Name | HERITAGE CARE HOME OF TAYLORSVILLE
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 668 WOOD ROAD
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City | TAYLORSVILLE
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State | NC
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Zip | 28681
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Country | US
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Telephone | 855-593-8766
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Fax |
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Provider Business Mailing Address
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Address Line | 42020 VILLAGE CENTER PLAZA STE 120-176
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City | STONERIDGE
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State | VA
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Zip | 20105
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Country | US
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Telephone | 855-593-8766
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | SYED JAVED
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Credential |
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Telephone | 855-593-8766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | NULL
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